NPIMap

Individual provider Active NPI

Diana M Addis, MD

  • Surgical Oncology Physician
  • Sparta, NJ
National Provider Identifier
1235241597
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
25MA07065800 Issued in NJ
Practice address
89 Sparta Ave
Suite 210
Sparta, NJ 07871-1777
Phone
(908) 918-0001
Fax
(908) 918-0003
NPI assigned
Aug 31, 2006
Last updated
Jul 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA07065800 NJ
Surgical Oncology Physician 2086X0206X 25MA07065800 NJ Primary

Addresses

Primary practice location

89 Sparta Ave
Suite 210
Sparta, NJ 07871-1777

Mailing address

98 Ford Rd
Suite 3-H
Denville, NJ 07834-1374
Phone (973) 625-3366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050831000122 NJ Practitioner - General Surgery 7517996085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Rutgers New Jersey Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group PAGroup PAC ID 5395642276, 1,204 clinicians

Practice addresses (Care Compare)

1 Diamond Hill Rd
Berkeley Heights, NJ 07922-2104
Phone (908) 273-4300

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy38
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group PA CurrentSince Jul 22, 2011 Accepting new patients
Summit Medical Group PA CurrentSince Jul 22, 2011 Accepting new patients
Mount Sinai School of Medicine Past Accepting new patients
Summit Plastic Surgery, PC Past Accepting new patients
Renee Comizio MD LLC Past Accepting new patients
Summit Medical Group, Inc Surgery Past Accepting new patients

Locations

1 Diamond Hill Rd
Berkeley Heights, NJ 07922
Phone (908) 277-8868

150 Floral Ave
New Providence, NJ 07974
Phone (908) 588-3890

Interoperability endpoints

  • Direct secure messaging: diana.addis.1@2983.direct.athenahealth.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1235241597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 FORD RD",
            "address_2": "SUITE 3-H",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078341374",
            "telephone_number": "973-625-3366",
            "fax_number": "973-625-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SPARTA AVE",
            "address_2": "SUITE 210",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711777",
            "telephone_number": "908-918-0001",
            "fax_number": "908-918-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDIS",
        "first_name": "DIANA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA07065800",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NJ",
            "license": "25MA07065800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.